Can Emergency Medicine be considered primary care?

[iTcanBdone]

I believe technically its isn't however I don't quite understand why not. Can anyone shed some light on why or has emergency medicine been adopted as a primary care specialty? I feel like emergency medicine is practically a primary field of medicine as far as treatment goes. Thoughts?

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[docterjew]

Primary care physicians take long term care of their patients. Pediatricians, family practitioners, internists, and OB/GYNs all have patients that they see for checkups and minor or chronic illnesses. They are able to build long lasting relationships with their patients, which is a big part of their attraction to these fields. Emergency physicians generally do not see patients over a long period of time. Unfortunately, some people treat the emergency department as their PCP's office, but this is not what it's intended for.

 

[iTcanBdone]

Primary care physicians take long term care of their patients. Pediatricians, family practitioners, internists, and OB/GYNs all have patients that they see for checkups and minor or chronic illnesses. They are able to build long lasting relationships with their patients, which is a big part of their attraction to these fields. Emergency physicians generally do not see patients over a long period of time. Unfortunately, some people treat the emergency department as their PCP's office, but this is not what it's intended for.

Ahhhh okay that makes sense, thank you for clearing that up for me!

 

[TXhopeful]

Agreed with the first response 100%. After being an ER scribe for 3.5 years, I've seen a major change in what presents to the ER just in my time there. If you look at some of the recent articles in EM journals/magazines it heavily discusses end of life care (which one typically does not view as an ER physician's job), managing chronic renal disease, diabetes, medication refills like crazy, wound rechecks, repeat lab work, etc. Along with that, the ER is open 24/7, 365 days a year....including after their PCP's office closes or on the weekends, leaving patient dumps and sending them to the ER for things needed to be handled in the office. If you ever shadow, scribe or do preceptorship in the ER, you will quickly see how many patients have no acute problems whatsoever. Also contributes to emergency medicine having the highest burnout rate with their docs.

 

[EMDO2018]

So then, is psychiatry considered primary care?

 

[cabinbuilder]

So then, is psychiatry considered primary care?

YES

 

[cabinbuilder]

Agreed with the first response 100%. After being an ER scribe for 3.5 years, I've seen a major change in what presents to the ER just in my time there. If you look at some of the recent articles in EM journals/magazines it heavily discusses end of life care (which one typically does not view as an ER physician's job), managing chronic renal disease, diabetes, medication refills like crazy, wound rechecks, repeat lab work, etc. Along with that, the ER is open 24/7, 365 days a year....including after their PCP's office closes or on the weekends, leaving patient dumps and sending them to the ER for things needed to be handled in the office. If you ever shadow, scribe or do preceptorship in the ER, you will quickly see how many patients have no acute problems whatsoever. Also contributes to emergency medicine having the highest burnout rate with their docs.

totally agree. I'm doing a short stint in a very large ER as an FP. It TOTALLY SUCKS. People come in for the STUPIDEST things that can be treated by going to Wal-Mart but they don't cuz Medicaid doesn't make then pay anything to be seen in the ER.

 

[iTcanBdone]

Agreed with the first response 100%. After being an ER scribe for 3.5 years, I've seen a major change in what presents to the ER just in my time there. If you look at some of the recent articles in EM journals/magazines it heavily discusses end of life care (which one typically does not view as an ER physician's job), managing chronic renal disease, diabetes, medication refills like crazy, wound rechecks, repeat lab work, etc. Along with that, the ER is open 24/7, 365 days a year....including after their PCP's office closes or on the weekends, leaving patient dumps and sending them to the ER for things needed to be handled in the office. If you ever shadow, scribe or do preceptorship in the ER, you will quickly see how many patients have no acute problems whatsoever. Also contributes to emergency medicine having the highest burnout rate with their docs.

Yeah I think this is probably why I thought it should have been considered primary care but I now see it wasnt intended to be that way.

 

[touchpause13]

It's not, but people use it as such unfortunately.

 

[AlbinoHawk DO]

So then, is psychiatry considered primary care?

Sometimes. Very gray zone.

 

[alpinism]

Traditionally, primary care was by definition fields that provided the primary point of contact for patients entering the medical system while also providing long term comprehensive care (i.e. generalists that deal with medical conditions affecting all parts of the body).

FM, general IM, and general Peds met that criteria.

Most basic psych issues can be managed by the above 3. The same goes for Ob/Gyn and Urology.

Unfortunately, many patients want immediate care and don't want to wait for referrals. As such, they either go straight to the ED for primary care or skip primary care docs altogether and go straight to specialists. Also, medical schools hoping to impress politicians and the general public started rebranding other fields as primary care in order to boost their numbers.

In truth, today almost any field besides anesthesiology, radiology, pathology, and neurosurgery can be considered "primary care."

 

[pattr]

Agree with the above. "Primary" care is the "primary" (first) physician you see to get treatment. In many cases the ER may be the primary point of care. However, EM does not fit the usual connotation of PCP's in that there is little to no follow-up.

I would consider the following primary care: FM, General IM and Pediatrics (including hospitalists)... and on the outskirts of that definition: general OB/GYN, Psych, EM.

 

[wjs010]

there are some parts of the country where EM is under the umbrella of primary care, meaning you can do the public service scholarship thing. I'm sorry I don't exactly where.

 

[Psychonergic]

In my community, rural psychiatry is run at a primary care pace, and you really get the chance to know your patients. I would agree about EM, too, especially around where I live and there is a far greater volume of elderly consumers than there are providers.

 

[iTcanBdone]

there are some parts of the country where EM is under the umbrella of primary care, meaning you can do the public service scholarship thing. I'm sorry I don't exactly where.

Awesome, thank you! I will do some research on that for sure! That's exactly why I was concerned about all this in the first place. I'm really interested in EM and thought I would qualify for some scholarships in my region but I wasn't sure if EM would suffice for a primary care based scholarships. I also wasn't sure if you stated that you were interested in EM in your personal statement, would the school you are applying to looking down on that if their focus is Primary Care?

 

[bcurtis]

If you went into emergency medicine and did an urgent care clinic, or an after hours clinic, it would be primary care then (but only then). You can argue that it is like a PCP hybrid, but it's just an argument. I feel the same way as you.

 

[wjs010]

Awesome, thank you! I will do some research on that for sure! That's exactly why I was concerned about all this in the first place. I'm really interested in EM and thought I would qualify for some scholarships in my region but I wasn't sure if EM would suffice for a primary care based scholarships. I also wasn't sure if you stated that you were interested in EM in your personal statement, would the school you are applying to looking down on that if their focus is Primary Care?

I'm not 100% sure. It could depend on the individual reading your Ps. Most likely though, they know all pre meds have "interests" and most end up changing during school. So just be honest and you'll be fine.

 

[CajunMedic]

there are some parts of the country where EM is under the umbrella of primary care, meaning you can do the public service scholarship thing. I'm sorry I don't exactly where.

For some reason, Alabama comes to mind. IIRC, they mentioned EM being considered primary care there during my ACOM interview

 

[wjs010]

For some reason, Alabama comes to mind. IIRC, they mentioned EM being considered primary care there during my ACOM interview

They mentioned that at my int too. I didn't know if it was all of the southeast or just in Alabama.